You can't tell by looking.
Open the door to conversation.
Signs and symptoms:
(Note: please screen EVERY Mom; pediatric and primary care providers, please also screen every Dad/partner. Remember, perinatal mood disorders are the #1 health complication related to pregnancy and postpartum. We MUST normalize the conversation about the existence/occurrence.
This is NOT an exhaustive list of symptoms. Please call us if you are interested in ACPMHC doing a training for you and your staff.)
From mild TO severe:
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sadness that lightens easily TO continuous sadness and misery
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occasionally feeling "edgy" and tense TO unrelenting dread/anguish/panic
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slight difficulty getting to sleep TO less than two or three hours of sleep
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slightly reduced appetite TO has to be persuaded to eat
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repetitive negative/scary intrusive thoughts about baby's well-being, health/well-being of her/himself or others
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occasional difficulty in concentrating TO unable to read or carry conversation without great initiative and effort
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mild difficulty doing daily activities TO unable to do daily activities without assistance
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reduced interest in surroundings & friends TO emotionally paralyzed; inability to feel anger, grief, pleasure
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mild thoughts of inferiority TO delusions of ruin, remorse or unredeemable sin
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fleeting suicidal thoughts TO history of severe depression and current preparations/plans for suicide
To remember:
The "baby blues" are a normal hormonal adjustment to post-delivery. Mood lability should be MILD and easily resolved without special intervention. This should not last more than 12 days maximum.
IF symptoms are more than mild- it's NOT the "baby blues." If symptoms are mild or greater and persist outside of 12 days- it's MORE than the "baby blues."
Suggested ways to open the door to conversation:
(Note: these are suggestions- the focus is creating space for your patient (or your patient's caregiver) to receive care and understand she/he is not alone or to blame for experiencing emotional distress. This is KEY to connecting with your patient's potential emotional health needs.)
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Emotional health complications are very common during and after pregnancy; in fact, they are more common than many other physical health conditions. We want to help support your total health.
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We ask each parent to answer a questionnaire and then have an opportunity for a conversation. There are no WRONG answers and no one "fails" the questionnaire.
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Being pregnant/Being a parent is challenging for most of us, and every parent deserves support. Do you have any concerns you'd like us to talk about?
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Experiencing emotional distress does not mean you aren't a good (mom/dad/spouse, etc.). Help and support are available.
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Taking care of yourself is important for fulfilling your other roles.
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I can see that you are very excited about being pregnant; is there anything you are concerned or worried about?
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Being a parent it often helps to have a good support system, can you share who may be part of yours?
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As adults, we often put on our "happy face" to deal with stress in our lives. I want you to know we welcome the opportunity to talk about both the positive and the challenges you may be experiencing.
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Experiencing emotional distress is nothing to be ashamed of; it is easily treated and we will connect you with the right care and support.
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It sounds like you are having many strong feelings, support is available. I would like to talk more about the way you've been feeling (questions here regarding any current intention to harm self or others- versus negative intrusive thoughts; active plan ?; means to carry plans out; history of suicide attempts?)
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IF concerns about parent or baby safety (note: follow your existing crisis protocols)- "You and baby deserve for you to feel well. Let's talk about ways we can support you.
The ACPMHC does not provide crisis services. We can help you find a qualified referral source.
CRISIS NUMBERS:
Alachua County Crisis Center (352) 264-6789
National suicide prevention hotline (800) 273-8255